| NPI | 1891895280 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: FL ME31130) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: FL ME31130) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2011-03-16 |